Individual
REBECCA HEMA MANGALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 425-2285
(386) 425-4577
Mailing address
145 CITY PLACE, SUITE 101, PALM BEACH, FL 32164
(386) 302-0975
(386) 306-0976
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9105157
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008265500
—
FL
01
—
Y0EM6
BCBS
FL
Enumeration date
04/01/2011
Last updated
05/14/2021
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